ROC: Resuscitation Outcomes Consortium

The mission of the Resuscitation Outcomes Consortium (ROC) is to conduct clinical trials and other outcome-oriented research in the areas of cardiopulmonary arrest and severe traumatic injury. The lead sponsor for the consortium is the National Heart Lung and Blood Institute. The focus is on out of hospital and early hospitalization interventions. The principal investigator for the Pittsburgh site is Clifton Callaway, MD, PhD. Samuel Tisherman, MD, is the local principal investigator for the trauma trials.

The cardiac arrest group has conducted a trial of two interventions: 1) different durations of chest compressions by emergency medical service (EMS) providers prior to analysis of cardiac rhythm, and 2) use of the inspiratory threshold device during cardiopulmonary resuscitation (CPR). The study was stopped for futility after approximately 11,500 subjects had been enrolled. A secondary study at several ROC sites revealed that the use of real-time audio feedback to EMS providers improved CPR performance, but not restoration of pulses or survival to discharge.

The trauma group has conducted trials of administration of hypertonic saline to trauma victims with either hemorrhagic shock or traumatic brain injury. Both trials were stopped early for futility. Secondary analyses of these databases are underway. While discussions have been underway to plan the next interventional trial, an observational study in hypotensive trauma patients (Prospective Observational Prehospital and Hospital Registry for Trauma) has been initiated to evaluate the ability of pre-hospital factors to predict injury severity and mortality. Frank Guyette, MD, of Pitt’s Department of Emergency Medicine, is leading a sub-study of pre-hospital lactate determination.